Trained registered nurses/endoscopy teams can administer propofol safely for endoscopy

Douglas Rex, Ludwig T. Heuss, John A. Walker, Rong Qi

Research output: Contribution to journalArticle

218 Citations (Scopus)

Abstract

Background & Aims: Propofol has advantages as a sedative for endoscopic procedures. Its administration by anesthesia specialists is associated with high cost. Administration by nonanesthesiologists is controversial because of concerns about safety, particularly respiratory depression. Methods: Three endoscopy units developed programs to train registered nurses supervised only by endoscopists in the administration of propofol for endoscopic procedures. The rate of adverse respiratory events was tracked from the inception of the programs. To estimate whether training nurses to give propofol on a widespread basis might be effective, we evaluated the individual safety records of all nurses and endoscopists involved in propofol delivery at the 3 centers. Results: Among a total of 36,743 cases of nurse-administered propofol sedation (NAPS) at the 3 centers, there were no cases requiring endotracheal intubation or resulting in death, neurologic sequelae, or other permanent injury. The rate of respiratory events requiring assisted ventilation was not significantly different among the 3 centers and ranged from just <1 per 500 cases to just <1 per 1000 cases among the 3 centers. There was no individual nurse or physician for whom the rate of respiratory events requiring assisted ventilation differed from the overall rate of events at the respective centers. Conclusions: Trained nurses and endoscopists can administer propofol safely for endoscopic procedures. Nurse-administered propofol sedation is one potential solution to the high cost associated with anesthetist-delivered sedation for endoscopy.

Original languageEnglish
Pages (from-to)1384-1391
Number of pages8
JournalGastroenterology
Volume129
Issue number5
DOIs
StatePublished - Nov 2005

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Propofol
Endoscopy
Nurses
Respiratory Rate
Ventilation
Safety
Costs and Cost Analysis
Intratracheal Intubation
Hypnotics and Sedatives
Respiratory Insufficiency
Nervous System
Anesthesia
Physicians
Wounds and Injuries

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Trained registered nurses/endoscopy teams can administer propofol safely for endoscopy. / Rex, Douglas; Heuss, Ludwig T.; Walker, John A.; Qi, Rong.

In: Gastroenterology, Vol. 129, No. 5, 11.2005, p. 1384-1391.

Research output: Contribution to journalArticle

Rex, Douglas ; Heuss, Ludwig T. ; Walker, John A. ; Qi, Rong. / Trained registered nurses/endoscopy teams can administer propofol safely for endoscopy. In: Gastroenterology. 2005 ; Vol. 129, No. 5. pp. 1384-1391.
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